This article was produced as a project for the Dennis A. Hunt Fund for Health Journalism, a program of the USC Annenberg Center for Health Journalism. It's the fourth in a series of stories exploring how the Trump administration's immigration policies are affecting the physical, mental and emotional health of the kids of undocumented immigrants and health providers and educators who work with them.

"Early childhood exposure to stress and adversity does not only cause poor health and impaired development in the short term; the issues can persist into adulthood." (Getty Images)

Shielding parents from ICE carries health costs.

U.S. News

Monday, December 18, 2017

At an age when most kids are preoccupied with video games, bicycling and playing with friends, David, 9, worries that his mom, from Mexico, will be picked up by U.S. Immigration and Customs Enforcement agents. (David is a pseudonym. U.S. News is not identifying him by his real name to protect him and his mother.) When he hears a knock on the front door of his family's home in of East Los Angeles, David scoots upstairs to look outside a window, looking out for ICE agents.

David is a U.S. citizen, by virtue of his birth in the country. The boy's when his mom, who toils as a housekeeper, leaves their home to go to work. "He's very worried about me being alone on the street; he always wants to be with me," David's mom says. "On the days I work, he wants to stay attached to me."

For many immigrant families like David's, the Trump administration's has flipped the typical "parent-as-protector" dynamic. Terrified that ICE will take away their mother or father, many children of undocumented immigrants, including kids and teenagers, desperately want to shield their parents from ICE and possible deportation. Shouldering this kind of hyper-vigilance can make kids and teenagers of undocumented parents susceptible to an array of health problems, such as anxiety, , depression and , research suggests.

"It steals their life. They're not able to live the day-to-day life a child should live," says Dr. Charles Sophy, medical director of the Los Angeles County Department of Family Services. The department runs the nation's largest foster care system, which includes many immigrant families. "They see the fear in their parents, and they try to respond to it and alleviate it, which are things a kid shouldn't have to do. Living with that kind of fear has a big impact. It puts them at risk of continuing mental health problems that can preclude them from having a healthy, stable life because they've been 'parentified' and robbed of a secure childhood."

Another way U.S.-born kids of immigrant parents are "parentified" is when they represent their parents in encounters with health care workers, at the bank, at the Department of Motor Vehicles and with other institutions, says Marcelo Suárez-Orozco, the Wasserman dean of the graduate school of education and information studies at UCLA and co-author of "Children of Immigration" and "Learning a New Land." "This represents a reversal in traditional cultural roles and often makes children privy to information and facts they may not be developmentally ready to make sense of: sensitive medical issues when translating at the clinic or sensitive legal matters when it comes to immigration and related concerns. As ICE ramps up detentions and deportations, many children of immigrants will be put in the terrible situation of trying to mitigate the catastrophic impacts forceful [removals] are having on millions of immigrant families and their U.S.-born children."

A raft of research supports Sophy's and analysis. A study published in September in Science found that protecting unauthorized immigrant parents from deportation improves the . "Early childhood exposure to stress and adversity does not only cause poor health and impaired development in the short term; the issues can persist into adulthood," according to the study. Anxiety and psycho-social stress are risk factors for , , and , the study states. Other research has linked fear to weakening of , which in turn can make people vulnerable to gastrointestinal problems such as ulcers and .

The number of U.S.-born kids and teenagers living in daily terror that ICE will take away their parents is significant; about 4.7 million U.S. citizen children have at least one parent who's undocumented, according to 2014 estimates (the latest available) by the Pew Research Center. The effect of fear on a child or teenager's well-being can affect their performance in school, which can negatively influence their academic performance and in the long run damage their chances of attaining good jobs with health benefits, says Edward Vargas, an assistant professor at the School of Transborder Studies at Arizona State University in Tempe, Arizona.

"We are finding evidence that young scholars in mixed-status families are opting out of extracurricular activities in school such as being in marching band, playing sports or participating in other clubs," Vargas, says. "This is concerning as there are decades of research that show the importance of extracurricular activities on academic performance and college admissions."

Intense fear of ICE can weigh on even the best and most highly-motivated students – such as Edgar, 15, who lives with his mother. ("Edgar" is a pseudonym. U.S. News is not using his real to protect him and his mother.) He attended Dolores Mission School, which is part of the Dolores Mission Church parish in a heavily-Latino, poor Los Angeles neighborhood about 2 miles east of the skyscrapers and shiny, expensive apartment buildings of downtown. Thanks to his stellar grades, Edgar won a scholarship to a highly-regarded private high school in Los Angeles, where the tuition is more than $20,000 annually.

Getting a top-flight education could provide Edgar a way to get out of a and gang violence, but since Trump's election, he's been too preoccupied with fears that ICE will snatch his mom to concentrate on his studies. "I want to be with her at all times, I don't want her to be deported," Edgar says. He's attended a "know your rights" seminar for undocumented immigrants and thinks he could shield his mom if ICE agents were to detain her. "I could be her translator, talk to the cop," he says. "The only thing that stops me is going to school."

One young child of an undocumented immigrant mother from Central America had no illusion that he could save her from ICE. Instead the boy, age 7, tried to help prepare for a deportation by eating less, to save his cash-strapped mom money, because he believed they would be poor in her native country, says Paula Ruiz, a bilingual therapist at Children's Bureau – Magnolia Place, a nonprofit organization near downtown Los Angeles that provides an array of social services to more than 30,000 children and families annually. Many of the people the center services are immigrants from Central America, South America, Mexico and South Korea.

The chances that any particular undocumented immigrant – such as David's or Edgar's mom – will be deported are long, but, under the Trump administration, much greater than they had been under previous administrations. Former President Barack Obama's policies were designed to deport those who posed a public safety threat, according to Wendy Feliz, communications director for the American Immigration Council, an immigrant advocacy group. Under the Trump administration, ICE agents are arresting people regardless of whether they've been charged with a serious crime, and are working with some local police agencies to detain undocumented immigrants. This approach has led to a huge bump in detentions: From Jan. 20, 2017 through Sept. 30, during Trump's first nine months in office, ICE made 110,568 arrests, compared to 77,806 during the same time period the previous year, during the Obama administration, says Danielle Bennett, an ICE spokeswoman.

When kids become "parentified" and try to shield their mothers and fathers from ICE, it could affect their undocumented parents, says Rona Preli, an associate professor of marriage and family at Fairfield University in Fairfield, Connecticut. The school has a free clinic that provides free to people with no financial resources; many of the facility's clients are undocumented immigrants from South America, the Caribbean, Mexico and Eastern Europe. "Parents may become upset and blame themselves and feel like they're failing," Preli says. "The worry and stress around deportation for undocumented parents can interfere with their ability to parent, practically and psychologically, making them feel like they are failing as parents."

Sophy, of the Los Angeles County Department of Family Services, agrees. "The parents don't feel good about it either, they feel inadequate and worry they're doing a bad job [raising their kids]," he says. "The whole demeanor in the house becomes negative and sad."